药物涂层球囊在冠脉分叉病变分支血管中的应用价值

Application of Drug-coated Balloon in Small Branch Ostial Lesions in Coronary Bifurcation Lesions

目的:评价药物涂层球囊(drug-coated balloon,DCB)在冠脉分叉病变分支血管中的安全性和远期疗效。方法:将入组的84例患者分为DCB血管成形术治疗组(DCB组)38例和切割球囊(cutting balloon,CB)血管成形术治疗组(CB组)46例。分析比较两组术中即刻效果及远期预后。结果:DCB组扩张后即刻最小管腔直径(minimal lumen diameter,MLD)为(2.02±0.44)mm,直径狭窄率为(21.87±10.54)%,与CB组的(2.11±0.32)mm、(22.65±11.43)%比较,差异均无统计学意义(P>0.05)。术后6个月,DCB组的MLD(1.88±0.21)mm,明显高于CB组的(1.23±0.38)mm,差异有统计学意义(P<0.05),且直径狭窄率(31.20±18.47)%,显著低于CB组的(48.65±23.56)%,差异有统计学意义(P<0.05)。DCB组再狭窄率10.53%,低于CB组的26.09%,差异有统计学意义(P<0.05)。结论:在冠状动脉分支开口病变治疗中,DCB与CB治疗相比,即刻效果相似但远期疗效优于CB。

Objective：To evaluate the safety and long-term efficacy of drug-coated balloon（DCB） in small branch ostial lesions in coronary bifurcation lesions.Method： A total of 84 patients were enrolled in the study and randomly divided into the DCB angioplasty group with 38 cases and the cutting balloon（CB） angioplasty group with 46 cases.The immediate outcomes and long-term efficacy were investigated.Result： The minimal lumen diameter（MLD） of immediately after dilatation in in DCB group was （2.02±0.44）mm,and the diameter stenosis rate was （21.87±10.54）%,and （2.11±0.32）mm,（22.65±11.43）% in CB group,there were no significant differences between DCB group and CB group（P〉0.05）.At 6 month follow-up study,the DCB group showed significantly larger in the MLD of （1.88±0.21）mm than the CB group of （1.23±0.38）mm,the differences was statistically significant（P〈0.05）;and the diameter stenosis in the DCB group was （31.20±18.47）%,lower than （48.65±23.56）% in the CB group,the differences was statistically significant（P〈0.05）.Furthermore,the recurrent restenosis rate of 10.53% in the DCB group was significantly lower than 26.09% in the CB group,the differences was statistically significant（P〈0.05）.Conclusion： The immediate outcomes between DCB and CB were similar in small branch ostial lesions for coronary arteries angioplasty.The long-term efficacy of DCB angioplasty is better than CB angioplasty.